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A method was developed for testing the cytotoxicity of various bandage-like wound dressings and gel wound dressings. In this method, the ability of human polymorphonuclear neutrophils (PMNs) to initiate a respiratory burst after exposure to the various wound dressings is used as a marker of cytotoxicity. Luminol-amplified chemiluminescence stimulated with opsonised zymosan or phorbol 12-myristate 13-acetate (PMA) is used to measure the degree of activation of the respiratory burst, i.e. the NADPH oxidase activity, after exposure to wound dressings. Opsonised zymosan (material from yeast cell walls) is a phagocytic stimulus that activates the NADPH oxidase by binding to FC-receptors and complement receptors, and functions as an artificial bacterium, whereas PMA activates the NADPH oxidase by direct activation of protein kinase C. NADPH oxidase activity was inhibited by several wound dressings. The down-regulation of the respiratory burst is detrimental to the bactericial effect of PMNs, and can be used as a marker for the cytotoxicity of wound dressing materials.

A rapid screening method was developed for assessment of the toxic effects of fluid materials on the respiratory burst response of polymorphonuclear neutrophils (PMNLs). The method was used to detect adverse effects of peritoneal dialysis (PD) fluids. Intoxication of the respiratory burst response attenuates the bacterial killing capacity of PMNLs, and increases the sensitivity of patients to peritoneal infection. Capillary blood was taken from healthy donors, placed in drops on commercially available titanium pieces, and incubated in a humidified chamber at 37°C for up to 1 hour. The blood was rinsed off with saline, and the adhering cells were characterised by immunofluorescence by using antibodies directed against specific cell-differentiation antigens. A majority (> 95%) of the adhering leucocytes were PMNLs. The surface expression of selectins was down-regulated after 30 minutes, and the expression of integrins was down-regulated after blood exposure for 1 hour. NADPH-oxidase activity of the adhering cells was stimulated by f-MLP peptide and by opsonised zymosan. The zymosan-induced activation showed a lag-phase after 1 hour, consistent with the down-regulated expression of integrin. The zymosan-stimulated enzyme activity was used as an indicator of the cytotoxicity of PD fluids. NADPH-oxidase activity was inhibited by PD fluids with a pH of 5.7 and by heat-sterilised PD fluids. The results were compared with data obtained by using isolated circulating cells and cells from peritoneal dwell fluid., (2000 FRAME.)